ABSTRACT
Carotid artery intima media thickness estimation is a well-established way of cardio vascular disease evaluation. The purpose of this cross-sectional study was to develop normal carotid intima media thickness percentile values for a Pakistani cohort. Data was collected at the Departments of Radiology and Family Medicine, The Aga Khan University Hospital, Karachi, from April 2014 to August 2015. High frequency ultrasound of carotid was done in 257 patients [97 male [38%], 160 female [62%]] without any known carotid artery disease. Reference ranges [90% range between 5th and 95th centiles] were constructed for each common carotid and internal carotid artery measurement and displayed in graph form. The mean difference was found in left common carotid artery [0.55 +/- 0.13] and left internal carotid artery thickness [0.50 +/- 0.10] significant at p=0.031 and p=0.014, respectively. The IMT percentile graphs developed in this study for internal and common carotid arteries are exclusive for this population and can be used to assess vascular health from ultrasound measurements
ABSTRACT
Objective: To assess availability and establish the current situation of essential human resource shortage for provision of emergency obstetric and new born care in public sector health facilities
Study Design: Observational / descriptive / cross sectional study
Place and Duration of Study: This study was conducted at the Department of Public Health, Contech School of Public Health, Lahore from January 2013 to December 2013
Materials and Methods: A robust surveys were conducted by stratified sampling technique by taking 100% samples. 20% sample of basic health units was taken to assess the availability of essential human resource for health to meet the progress of Millennium Development Goal 4 and 5
Results: Situation of availability of essential human resources at district and tehsil level for provision of maternal and newborn health services was found only 33% at district head quarter hospitals and 3% at tehsil headquarter hospitals. This is an escorting cause of not reducing maternal and child mortality as per target
Conclusion: Study results suggest accelerated provision of essential human resource for health to provide emergency obstetric and new born care to reducematernal and neonatal mortality in the country
ABSTRACT
To identify the effect of Vitamin D in reducing the risk of preeclampsia in pregnant women. The review was conducted from December 2011 to March 2012 at the University of Sheffield. Studies were included from the Medline data base, Web of Science [Web of Knowledge], Ovid database and Google Scholar. Studies were limited to published literature only; published between January 1992 to March 2012. A total of seven studies were selected for this review based on the inclusion criteria. One was non-r and omized clinical trial, three were cohort studies and three were nested case-control studies. The clinical trial showed a positive association between Vitamin D supplements and the reduction of preeclampsia risk in pregnant women. In addition, one large cohort and two nested case-control studies also showed a protective effect of vitamin D in preventing the risk of preeclampsia. However, the other two cohort studies and a nested case-control study could not find any association between vitamin D levels and the risk of preeclampsia in pregnant women. The studies included in this review show conflicting results about the association of vitamin D levels and the risk of preeclampsia. However, in this review more than half of the studies showed a positive link between Vitamin D deficiencies and Preeclampsia. There is a clear need for further trials and other robust studies to identify the effect of Vitamin D on preeclampsia.
ABSTRACT
Wilms tumor and hepatoblastoma are the most common intra-abdominal solid organ childhood tumors. CT examination is one of the routinely performed procedures in hospitals for children with these tumors inspite of high radiation exposure associated with CT scans. Sixty patients [Wilms tumor = 45, hepatoblastoma = 16] were evaluated retrospectively. Higher proportion [44.4%] of metastatic disease was identified at presentation in the Wilms tumor subset as compared to hepatoblastoma [6.3%] [p=0.006]. Metastatic disease was noted in 6 patients having Wilms tumor on follow-up while it was also low in hepatoblastoma which was noted in only 2 patients [p > 0.05]. No significant difference was identified in pelvic extension of disease at presentation in both studied population [p > 0.05]. Pelvic metastasis was noted in 1 patient only with Wilms tumor on follow-up while no pelvic metastasis was seen in the hepatoblastoma patients [p-value > 0.05]
ABSTRACT
To evaluate the role of ultrasound in the diagnosis of patients with suspected Infantile Hypertrophic Pyloric Stenosis [IHPS] who do not have a clinically palpable 'pyloric lump' or olive by taking surgery and follow-up as gold standard. Validation study. Radiology department at National Institute of Child Health [NICH], Karachi from January 2008 to March 2010. Appropriate technical and ethical approval for the study was obtained. Twenty eight consecutive patients [22 males and 6 females] with clinical suspicion of IHPS without a definite palpable 'pyloric lump' referred to radiology department of National Institute of Child Health [NICH] were included in the study. All patients underwent ultrasonography by an experienced consultant radiologist. Patients were categorized as having or not having IHPS. The results were compared with follow up at surgery for those declared as having IHPS on ultrasound and clinical follow up for those not having IHPS on ultrasound. Sensitivity, specificity, negative predictive value [NPV] and positive predictive value [PPV] of ultrasound were calculated. Twenty four patients were diagnosed with IHPS. Four were diagnosed as not having IHPS. Out of these 4 patients 1 was subjected to barium meal examination. Patients were followed up to confirm the ultrasound findings or otherwise. Ultrasonography yielded a sensitivity of 96% and specificity of 100% in diagnosing IHPS in patients without a palpable 'pyloric lump' or 'olive'. The positive predictive value of ultrasonography in these patients was 1.00 and the negative predictive value was 0.75. Ultrasonography should be the initial investigation in patients with clinical suspicion of IHPS and an impalpable pyloric lump to improve early diagnosis in these babies
ABSTRACT
To estimate the frequency of needle stick injuries [NSI] among health care workers [nurses, student nurses and paramedical staff] in public hospitals of Karachi. Cross sectional, observational. This study was conducted in three public tertiary care hospitals of Karachi, from November 2007 to January 2008. Data was collected by structured interview-based questionnaires in Urdu and English language. Questionnaire was designed to obtain information regarding demography, work experience, hepatitis vaccination status, and occurrence of needle stick injuries with associated factors. Needle stick injury that occurred in the previous month was the defined outcome. Data was entered in Epi Data and analyzed in SPSS version 15. A total of 417 health care workers participated in the study. Mean age of the participants was 24 +/- 11 years. Estimated proportion of participants with history of at least one time NSI was found in 66%. Around 13% [n=54] had one or more NSI in the previous one month at work and half of them were affected by non-sterile needle. None of them sought medical care. Almost 90% of them were not wearing gloves or taking any other protective measures at the time of injury. There can be serious consequences of needle stick injuries in public hospitals as large proportion of injuries involve non-sterile used needles and health care workers do not take appropriate measures of protection